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How Living with a Depressed Person Can Impact Your Relationship

Living with a depressed person isn't easy and can put a lot of stress on a relationship. Here are 9 rules for living or working with a depressed person.

The couple sitting opposite me in my Tampa offices look like a nice couple. They are polite to each other. They even love each other, so they say. But the marriage is ending. She wants out.

"I can't live with his depression," she says almost as soon as they've sat down. "It's his negativity, he's constant looking on the dark side of everything. And I'm always making excuses for him--he won't let me tell people the truth about his depression, so I have to lie for him!"

Living, working or having a close relationship with somebody who suffers from depression is not easy, even if they're one of the lucky 30% who is really helped by antidepressants. Often they feel guilty, or ashamed, about being depressed. Sometimes their depression will take the form of anger at you or others. Sometimes it may cause them to sabotage or harm themselves. If they're honest they will complain of the pain the illness causes, if they're less than frank they'll withdraw or blame you for their depressed state. You may well feel you're in a lose-lose situation.

The real danger in any relationship with someone who has a serious illness is that you and he or she will become codependent around the problem. This is most obviously true with alcoholism, but the same forces are at work in cases of cancer, or HIV or depression. Lying for someone, making excuses for them or pretending the problem doesn't exist is part of the codependence spectrum.

The trick to surviving in a relationship with a depressive--or an alcoholic for that matter--is to firmly maintain your boundaries, or, as we would put it, be aware of and insist on getting your needs met. Any relationship is a mutual satisfaction of needs, regardless of either party's state of health.

Establishing clear and consistent boundaries can be very hard because often our natural inclination is to try to make the sufferer feel better, to rescue. I have known people who have gone broke trying to appease the demands of the inner demons that torment their partner, trying to make it right for them, trying to make them happy.

In the book Creating Optimism: A Proven, 7-Step Program for Overcoming Depression, which I wrote with my wife and partner (and former sufferer of treatment-resistant depression) Alicia Fortinberry, I included an appendix living with a depressive. In it I laid out nine rules for living, or working, with a depressed person (these rules work for living or working with people with addictions as well).

The rules are:

Understand the disorder. Take time to find out what depression is and is not. So many popular misunderstandings about the illness and so much denial about its origins exist.

Keep in mind that he can't "snap out of it." Remember that the other person has a real illness. Like someone with cancer, they can't simply "get over it." Try not to express your frustration or anger in ways you'll regret, but don't suppress your own feelings either. You can say for example, "I know that you can't help feeling down, but I feel frustrated." If the person is an unrelenting pessimist, as so many people with depression are, try to point out the positive things that are happening. His negative childhood programming--the "inner saboteur"--will probably prevent him from seeing these for himself. The depressive illness has a vested interest in the lie that nothing will go right.

Ask about his feelings and his childhood programming. Encourage your friend to discuss his feelings with you. Your ability to listen non-judgmentally will be helpful in itself. It will also give you the opportunity to learn about his childhood pattering and what role you are playing in regard to it. Who do you represent to him from his early life? What actions of yours may be triggering depressive episodes?

Admit your own powerlessness against the disorder. Many people believe they can cure someone they love just by the sheer force of their love, as if that feeling alone should be enough to effect permanent change. It isn't. The first stage to avoiding guilt over someone else's depression is to acknowledge that you are not responsible for it. It's not your fault, and you alone can't cure it. You can offer support, you can show friendship or love, whichever is appropriate, but you are probably too close to be able to solve the problem. Step back, admit that you alone are powerless against the disorder. Seek support for yourself from friends and perhaps a psychotherapist. The first stage toward helping the other person is to get help for yourself.

Do not try to rescue. A person suffering from a mood disorder will probably be a slave to his depressive program. The disorder will infantilize him, and he may well put pressure on you to fix whatever he perceives to be the problem. Sometimes the program can be temporarily assuaged in this way and the depression will lift. But it will come back and the inner saboteur will make even more demands. You may be forced into trying to play the role of omnipotent parent and feel guilty when you fail to provide what is demanded of you.

Don't make excuses for him. Never become part of the depressed person's denial. Don't lie for him. Making excuses or covering up for a friend or colleague only prevents him from getting timely help. In the addiction field this is called "enabling." Ultimately it may do him harm and delay his recovery.

Encourage him to seek help. Many sufferers from depression deny that they have the disorder or try to self-medicate with alcohol (as my mother did) or overwork or shopping--all of which are depressives in the long run. Part of your self-preservation is getting the depressed person in your life to seek professional help. This is true whether you live or work with him.

Discover your own programming. It's important to realize that the other person's depression is playing a role in your inner saboteur's game. In clinical terms you may be getting a "secondary gain" from his disorder. His behavior may seem to give you an excuse to vent angry feelings, or an opportunity for you to play the knight in shining armor or perhaps a reason to excuse your own real or imagined shortcomings. If you find yourself having relationships with a number of people who are depressed, there's probably a reason in your own past. Seek help in dealing with those emotions and fears.

Tell him what you need. The depressed person in your life may be ill, but you still have needs of him. All relationships are based on the mutual meeting of needs.

If you aren't honest about what you're getting from the relationship, or what you want to get, you will make the other person feel even worse about himself. If you follow the guidelines in our book Creating Optimism you'll learn how to identify your own needs and boundaries and be true to them. You'll also know when it's OK for you to compromise and when it's not. Be honest about what you can and cannot do, and about what you will and won't do. Never promise what you can't fulfill. You may often be asked to.

On the other hand, going through the process of exchanging real, functional needs with the depressed person can be a very powerful healing tool for both of you.

Above all remember that even the worst depression is curable, even if you alone can't cure it. The turning point can come at any time, maybe without your even realizing it. If you and your friend do what we suggest, the real person you chose to live with or to work with will come back to you for good.

About the author: Dr. Bob Murray is a bestselling author, relationship expert and psychologist. He is also founder of the Uplift Program for overcoming mood disorders.